Objective: Although recombinant human erythropoietin (rhEPO) has revolutionized the treatment of anemia in chronic kidney disease (CKD) receiving hemodialysis (HD) with no need of blood transfusion, some patients have a blunted or appear to be resistant to rhEPO. There is a controversy in the causes of rhEPO resistance in maintenance HD patients with anemia. This study is to examine current anemia treatment outcomes and the factors influencing the rhEPO responsiveness in HD patient with CKD. Methods: The clinical parameters or factors relating to erythrompoietin treatment outcomes and erythropoietin responsiveness were collected from the HD patients in two large dialysis centers for three months. The collected paramenters included serum iron, total iron biding capacity (TIBC), transferrin saturation rate, ferritin, albumin, intact PTH, C-reactive protein (CRP), nPCR and medications such as an angiotensin converting enzyme inhbitor, an angiotension II receptor blocker and an HMG-CoA reductase inhibitor (HMG-CoA RI). The data were analyzed to examine the degree of acheiveing the anemia treatment goal and factors relating to ERI. Results: Among total 111 patients, 42 (42.3%) and 47 (37.8%) patients achieved the target Hct and Hb based on the Health Insurance Review and Assessment Services (HIRA) reimbursement criteria. In the higher ERI group (upper quartile), the patients had higher CRP levels (0.5 mg/dl) (p=0.0096), and lower TIBC score (<$240{\mu}g/dl$) (p=0.0027), and less patients were taking HMG-CoA RI (p=0.0019). Male patients (p=0.0204), patients with high TIBC score ($R^2$=0.084, p=0.0021) and patients taking HMG-CoA RI (p=0.0052) required to administer less dose of rhEPO meaning higher erythropoietin responsiveness. Conclusion: Less than 50% of CKD patients were achieving the goals of anemia by erythropoietin administration in large hospitals in Korea even though the goals were lower than those of NKF-K/DOQI practice guideline. The factors influencing ERI were sex, TIBC and HMG-CoA RI administration status, and neither an ACEI nor an ARB did not influence ERI.
Ahn, Hye Mi;Kim, Hyeongsu;Lee, Kun Sei;Lee, Jung Hyun;Jeong, Hyo Seon;Chang, Soung Hoon;Lee, Kyeong Ryong;Kim, Sung Hea;Shin, Eun Young
Journal of Korean Academy of Nursing
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v.46
no.6
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pp.804-812
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2016
Purpose: This research was done to identify the hospital arrival rate and factors related to prehospital delay in arriving at an emergency medical center within the golden time after symptom onset in patients with acute myocardial infarction (AMI). Methods: Data used in the research was from the National Emergency Department Information System of the National Emergency Medical Center which reported that in 2014, 9,611 patients went to emergency medical centers for acute myocardial infarction. Prehospital time is the time from onset to arrival at an emergency medical center and is analyzed by subdividing arrival and delay based on golden time of 2 hour. Results: After onset of acute myocardial infarction, arrival rate to emergency medical centers within the golden time was 44.0%(4,233), and factors related to prehospital delay were gender, age, region of residence, symptoms, path to hospital visit, and method of transportation. Conclusion: Results of this study show that in 2014 more than half of AMI patients arrive at emergency medical centers after the golden time for proper treatment of AMI. In order to reduce prehospital delay, new policy that reflects factors influencing prehospital delay should be developed. Especially, public campaigns and education to provide information on AMI initial symptoms and to enhance utilizing EMS to get to the emergency medical center directly should be implemented for patients and/or caregivers.
Diverse official policies in community are available for caregivers to take care of the elderly in the US and the UK. This study aims to examine the recent changes in government supports based on The Recognize, Assist, Include Support and Engage (RAISE) in the US, and those by Carer Act 2014 in the UK, to take any good lessons for Korean policy. Caregivers will play a new role to develop innovative treatment for patient-centered care. The UK strengthens to provide various efforts for working carers while assuring economic efficiency in labor market with empirical evidence. The major four ways to support carers were developed agreed with the acknowledge of caregiving value and their human right; financial support, direct services for carers, flexible work time, and advocacy. Korean supports policies for carers in long-term care and social welfare will be more effective in community care system if more evidence based policies are prepared.
The Journal of the Convergence on Culture Technology
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v.7
no.4
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pp.491-501
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2021
Purpose: This study is designed to provide care workers with basic data on the development of job training programs for enhancing professionalism of senior care services by identifying and analyzing job recognition and education requirements according to the type of work place. Methods: Data were collected from April to July 2019 from 177 care workers working at the Elderly Care Facilities, Elderly Housing Welfare Facilities and Rehabilitation Facilities in the B Metropolitan City. It was analyzed using the SPSS Win 21.0 Statistical Program. Results: The results of job recognition of care worker according to the type of work place shows as follows. As for health care welfare facilities for senior citizens and residential welfare facilities for the elderly was the highest level for physical change and mobile care protection belonging to basic care protection technologies. For the rehabilitation and welfare facility, human rights and prevention of abuse among senior citizens which is belonging to occupational ethics and attitudes of care workers showed the highest. Conclusion: It is required for differentiated job training to enhance capacity for care workers according to the type of work place, and it is needed to developed systematic and specific customized hands-on training to perform, not for simple knowledge.
Choi, Ki Bo;Lee, Song Mi;Lee, Seung Min;Lee, Eun;Park, Mi Sun;Park, Yoo Kyoung;Cha, Jin A;Lyu, Eun Soon
Journal of the Korean Society of Food Science and Nutrition
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v.46
no.2
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pp.251-258
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2017
The objective of this study was to analyze patient satisfaction and perception of nutritional counseling services quality. A patient satisfaction and perception survey was conducted for 1,095 patients from 43 tertiary hospitals and 20 general hospitals. The number of returned questionnaires was 656 (response rate: 60.0%). Data from 633 questionnaires were analyzed after the questionnaires with unanswered items were excluded. Five domains were identified from the result of the factor analysis using the maximum likelihood and oblique rotation. The five domains were named empathy, responsiveness, tangibles, reliability, and skill and specialty. Patient perception mean score of nutritional counseling was 4.54/5.00. Patient satisfaction scores were significantly higher in empathy (P<0.001), responsiveness, and skill and specialty (P<0.01) with a college or graduate school education than in patients with a middle school education. There was no statistically significant difference between satisfaction scores in tertiary hospitals and those in general hospitals, but patients in capital hospitals reported significantly higher scores than their local counterparts in empathy, responsiveness, reliability, skill and specialty (P<0.001), and tangibles (P<0.05). In responsiveness, significantly higher (P<0.01) scores were observed in patients who received nutritional counseling only once compared to patients who received counseling two times. Patients perception of nutritional counseling services was significantly correlated with their satisfaction of five domains, reliability (r=0.721), responsiveness (r=0.697), empathy (r=0.690), skill and specialty (r=0.678), and tangibles (r=0.622).
Lee, Insook;Kim, Sungjae;Bang, Kyung-Sook;Yi, Yunjeong;Kim, Miju;Moon, Hyojeong;Yeon, Poung Sik;Ha, Ei-Yan;Chin, Young Ran
The Journal of the Korean Institute of Forest Recreation
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v.22
no.4
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pp.59-69
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2018
This is a cross-sectional study that suggests ways to activate forest welfare services (FWS) by investigating the infrastructure, service status, and perception on FWS in Korea. In August 2016, a structured email survey was conducted in nation widely. The respondents were mostly directors and general secretary (75.0%). The considerable number (16.3%) of nursing homes (NH) use some floors of the complex buildings that would be difficult to have FWS infrastructure and about 30% of those without forests near the facilities. The directors of NH recognize that FWS has positive effects on the elderly. However, FWS is not an requisite of the longterm care insurance benefit, and so costly and effort-intensive that FWS has not been activated so far. In order to activate FWS in NHs, it is necessary to develop and disseminate the guidelines on FWS that anyone can easily followed. In addition, when the National Health Insurance Corporation evaluates NHs, they should evaluate not only whether there is a wandering or walking space, but also whether it has forest healing factors such as forests. It is also necessary to create a barrier-free environment both inside and outside of NHs, increasing accessibility to the toilet in gardens, paving a passage for wheelchairs and lifts in forests near NHs. Through these efforts, it is expected that FWS will be activated to provide physical, mental rest and comfort, appropriate cognitive stimulation to the NH residents at the end of life.
Journal of Korea Entertainment Industry Association
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v.13
no.8
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pp.411-424
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2019
The purpose of this study is to explore the feasible policy directions for sports welfare that can not only improve the standard of living through health but also ensure a happy and enjoyable life for the people of Gangwon Province. For this purpose, I have conducted studies such as the analysis on the sports class voucher project being implemented by the South Korean government and the case analysis in sports welfare, and present policy directions as follows. First of all, it is about upgrading the sports class voucher project. And as its implementation plans, I suggest ① increased publicity, ② the earmarking of the province's own budget for the sports class voucher project, ③ the establishment of a system for cooperation for work implementation between the related organizations and their staff in charge with a view to activating the sports class voucher project, and ④ the upgraded services for the sports class voucher project and the upgraded access to the life cycle-based universal welfare. Second, it is about using public sports facilities and developing various programs. I suggest the active utilization of the public sports facilities that enable people to learn the skills for such sports disciplines as baseball, badminton, ice sports, and golf and the development and distribution of distinctive educational programs for dance for media entertainment shows for female youths, climbing, cheer leading, fencing, surfing and horseback riding. Third, it is about nurturing the human resources and networking. For this, I suggest the creation of 'Sports Welfare Specialist Training Program' and the training of the college students majoring in sports science with the aim of creating a number of jobs. Fourth, it is about refurbishing the system and establishing the support system. I suggest the dismantling of the partitions in the welfare policy related to sports activities and the formation of (tentatively named) 'Gangwon Province Sports Welfare Implementation Committee', and the creation of (tentatively named) 'Sports Welfare Project Support Team' in Health, Welfare & Women's Affairs Bureau or Culture, Tourism and Sports Bureau in the short term and then its long-term expansion into (tentatively named) 'Gangwon Province Sports Welfare Support Center' in responding to the needs that reflect the provincial demographics, with a view to establishing a single lineup for the administrative support system. Furthermore, as budget and manpower are needed to realize customized sports welfare that suits the characteristics of the province and in which all the provincial residents can collect benefits, I suggest that the province provide the legal basis through creating 'Ordinance Promoting Sports Welfare in Gangwon Province' and pushing forward with (tentatively named) 'Gangwon Province Sports Welfare Competition' as what revises the sports class voucher project for the purpose of broadening the basis for sports welfare promotion.
Journal of the Korean Association of African Studies
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v.29
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pp.27-53
/
2009
At the start of the new century, South Africa probably had the largest number of HIV-infected people of any country in the world. The only nation that comes close is India with a population of one billion people compared to South Africa's figure of 57 million. The tragedy is that this did not have to happen. South Africa was aware of the dangers posed by AIDS as early as 1985. In 1991, the national survey of women attending antenatal clinics found that only 0.8percent were infected. In 1994, when the new government took power, the figure was still comparatively low at 7.6 %. The 2004 figure which has been published is 26.5%. This article tracks the epidemic globally, in the region and in South Africa. I explain some of the basic concepts around the disease and look at what may happen with respect to numbers. The situation is bad, and the number of people falling ill, dying and leaving families will rise over next few years. This will impact on South Africa in a number of important ways. This article assesses the demographic, economic and social consequences of the epidemic. It disposes of a number of myths and present the real facts. The AIDS in South Africa is not related to individuals only. It warns that AIDS in Africa is becoming a community and systemic problem. The acuteness of the problem does not stem merely from the fact that communities are affected, or could even be wipe out by the end of this decade, but from the fact that AIDS will place incredible burdens and obligations upon medical services, health care and religious communities such as churches. The facts confront churches' mission with the important question: who is going to take care of all the patients and where? The reality is that people dying of AIDS will have to be cared for at home by relatives and friends. A further question that arises is whether our people are prepared for this. AIDS was considered to be a homo-plague and the hunt was on for a scapegoat in the light of the fatal implication of the disease. At present we are in the strategic phase where we all realize that it will be of no avail to scare people with the ominous threat of AIDS AIDS destroys the optimism of our achievement ethics. This exposure of the culture of optimism is also an exposure of the so-called 'human basic fear which accuses Christianity that their concept of sin is a damper on man's search for liberation and basic need to be freed from all Imitation. AIDS is also a test for our ecclesiastical genuineness and the sincerity of our mission sensibility. It poses the question: How unconditional is Christian love? Is there room for the AIDS sufferer in the community of believers, despite the fact he is an acknowledged homosexual? The question to put to the church is whether the community of believers is an exclusive to put to the koinonia which excludes homosexuals. They may be welcome on principle, but in actual fact are not acceptable to the church community. As South Africa enters the new century, it is clear that the epidemic is not having a measurable impact. However, the impact of AIDS is gradual, subtle and incremental. The author's proposal of what is currently most needed in South Africa is that the little things will make a difference. It's about doing lots of little things better at grassroots level, with the emphasis on doing. There are so many community, churches and NGOs initiatives worth building on and intensifying. One must not underestimate the therapeutic value of working together in small groups to overcome a problem
Journal of the Korean Society of Food Science and Nutrition
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v.38
no.5
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pp.618-625
/
2009
The purposes of this study were to evaluate food safety knowledge and to assess home food safety performance of home-delivered meal service recipients. Two facilities providing home-delivered meal services for older adults were located in Seoul. A total of 120 service recipients were surveyed using an individual interview technique and 97 responses were used for data analysis. A statistical data analysis was completed using SPSS program (ver.14) for descriptive analysis, t-test, ANOVA, and correlation analysis. The majority of the participants were 70 years old or older and females. They perceived their health status as poor or very poor and took more than one kind of medicines. An average score of the food safety knowledge test was 11.48 based on 18 points (63.8%). The results revealed that the older adults knew the importance of hand washing but were not aware of when and how to wash hands. There was room to improve knowledge on cleaning and sanitizing fresh fruits and using wiping cloth. The knowledge score for each category was not significantly different by gender and age. The home food safety practices of the older adults was rated as 2.8 out of 4 points; the highest score was associated for proper food handling category and the lowest score was for cleaning and sanitizing. The worst performance was related to managing hand cuts and wounds (1.96). The total knowledge score and an average performance score were significantly correlated (p<0.01). Food safety education programs targeting the older adults who receive home-delivered meal services would improve the recipients' food safety knowledge and practices related to consumption of the meals at home. The programs should focus on not only improving food safety knowledge but also changing food safety practices.
An eating behavior research was done with 50 females at a buffet styled restaurant during their lunch time. Of the respondents, 52.0% were professional and 54.0% were graduate school graduates. Of the respondents, 58.0% of the company were friends and 24.0% were relatives. The average time period of eating was $93.0{\pm}23.4$ minutes. The average frequency of taking food was $4.0{\pm}1.1$ and the average frequency of taking food after satiety was $1.4{\pm}0.8$. It is significant that lower frequency of food consumption was directly proportional to the age groups of respondents. The average selected food items were $30.4{\pm}7.1$ out of 175 and the average weight of the consumed food was $995.0{\pm}240.9$ g. The older age group chose a similar number of food items, but the amount of each food item was considerably less than younger. So the younger the age group was, the more they ate. The average food items at one time was $7.1{\pm}2.2$ and the average food weight time was $233.7{\pm}69.7$ g. The percentage of respondents who evaluated themselves as 'ate too much' was 70.0% and those who evaluate themselves 'ate properly' was 14.0%. Most of them were satisfied with the buffet service. The average of number of food items consumed by respondents before cooking was $50.5{\pm}8.9$. The consumption of calories and nutrients was compared with the Korean Daily Recommended Dietary Allowances. The consumed calories were 60.9% of RDAs, protein 104.4%, calcium 77.1%, iron 129.8%, vitamin A 66.5%, thiamin 96.0%, riboflavin 95.7%, niacin126.6% and ascorbic acid 112.3%. This data exceeded 1/3 of the Korean Daily RDAs tremendously and tells us extreme overeating. The energy ratio of carbohydrate: fat: protein was 51.6: 29.9: 18.5. Caloric consumption of animal food was 27.9% and the consumption rate of the other nutrients from animal food was considerably high. But the consumption rate of vitamin A was 90.9% from vegetable groups. Accoding to this study, buffet service gives some advantages. It gives customers an good opportunity to vary their food intake, which enhances eating experiences and can cause an improvemont of food habits. But overeating is a problem. Therefore, we think it is necessary for those women who have influence over their family's food selection, to have nutrition education about a desirable order of eating a meal, food selection, and health problems due to overeating at buffet styled restaurant. There should be some improvement in the management of buffet service. For example, proper temperature, texture, and freshness of the food should be maintained. Prevention of mixed food smells should be considered as well. To lower the price it is desirable to reduce the number of similar items and to use seasonal food as much as possible. A buffet styled restaurant with less food items with cheaper prices is recommended. Various traditional food should be developed for the menu items. We expect buffet services to be sutable to maintain good health and to be popular to any eater.
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